STRESS RESPONSE IN PATIENTS WITH TEMPOROMANDIBULAR DISORDERS & FIBROMYALGIA

颞下颌关节紊乱病患者的应激反应

• 批准号: 8168487
• 负责人: RINSKJE DE LEEUW
• 金额: $ 8.8万
• 依托单位: UNIVERSITY OF KENTUCKY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-08-01 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8168487
• 关键词: Adult; Age; C-reactive protein; Childhood; Computer Retrieval of Information on Scientific Projects Database; Diagnostic; Distress; Equipment and supply inventories; Evaluation; Event; Fibromyalgia; Funding; Galvanic Skin Response; Goals; Grant; Hydrocortisone; Immune system; Individual; Institution; Interleukin-6; Interview; Kentucky; Life; McGill Pain Scale; Measurement; Measures; Monitor; Occupations; Orofacial Pain; Pain; Pain Clinics; Patients; Perception; Phenotype; Physiology; Pilot Projects; Psychosocial Stress; Questionnaires; Recruitment Activity; Registries; Research; Research Personnel; Resources; Salivary; Serum; Severities; Source; Stress; Surveys; Symptoms; Temporomandibular Joint Disorders; Testing; United States National Institutes of Health; Universities; Woman; Women' s Health; biological adaptation to stress; falls; heart rate variability; maltreatment; neuropsychiatry; psychologic; psychosocial; stressor; violence against women

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The overall goal of this proposal is to define the relationships between symptom severity, stress exposure, and stress physiology of women with temporomandibular disorder (TMD) with and without concomitant fibromyalgia (FM). Our overall hypothesis is that individuals with TMD can have variable intensity of symptoms and that those with concomitant FM will fall on the severe end of the spectrum. Further, symptom severity will correlate with stress exposure (e.g. childhood vs adult, life events vs daily hassles) and stress physiology (e.g., salivary cortisol, heart-rate variability). We will recruit individuals from the University of Kentucky orofacial pain clinic and the Kentucky Women's Health Registry. Subjects will be classified into TMD without FM, TMD with FM, and healthy age matched controls. We will recruit 30 women with TMD anticipating that at least half will have comorbid FM, and 15 healthy controls. We are limiting this pilot study to women because the large majority of patients are women and because we will be evaluating stressors as they pertain to women. Stress perception and exposure will be evaluated using well-validated survey instruments. All subjects will undergo evaluation of stress-response physiology including diurnal cortisol and ambulatory heart-rate variability to monitor autonomic activity. The specific aims to be tested are as follows: Specific Aim 1: To compare temporomandibular disorder (TMD; n=30) in the presence or absence of fibromyalgia (FM) with regard to severity of symptoms and stress physiology. Specific Aim 2: To determine the association between psychosocial stress and distress and symptom profile, diagnostic groups (TMD ¿ FM, n=30, and healthy matched controls, n=15) and stress physiology. Stress exposure measures and psychosocial phenotyping include the MINI Neuropsychiatric Interview, SF-12v2, CES-D, Scl-90R, MASQ, PSQI, Gracely Pain Scale, McGill Pain Questionnaire, Hassles & Uplifts Sclare, Perceived Stress Scale, PCL-C, Job Content Questionnaire, National Violence Against Women Survey, and the Psychological Maltreatment of Womens Inventory. Stress physiology phenotyping includes diurnal salivary cortisol levels to assess baseline HPA axis function, salivary cortisol measurement at 30 minutes post-waking to assess stimulated HPA axis function, heart-rate variability, and skin conductance. We will also measure serum interleukin-6 (IL-6) and C-reactive protein (CRP) levels to assess generalized immune system activation.

该副本是使用众多研究子项目之一 由NIH/NCRR资助的中心赠款提供的资源。子弹和 调查员（PI）可能已经从其他NIH来源获得了主要资金， 因此可以在其他清晰的条目中代表。列出的机构是 对于中心，这是调查员的机构。 该提案的总体目标是定义症状严重程度，压力暴露和温度暴露（TMD）（TMD）的症状严重程度之间的关系，有或没有纤维肌痛（FM）。我们的总体假设是，具有TMD的个体可以具有症状强度可变的，而伴随FM的人会落在频谱的严重端。此外，症状的严重程度将与压力暴露（例如儿童与成人，生活事件与每日麻烦）和压力生理学（例如唾液皮质醇，心率变异性）相关。我们将招募肯塔基大学的口腔疼痛诊所和肯塔基州妇女健康注册中心的个人。受试者将分为没有FM，具有FM的TMD和健康年龄匹配的对照的TMD。我们将招募30名具有TMD的女性，预计至少有一半将具有合并的FM和15个健康对照。我们将这项试点研究限制在女性中，因为大多数患者是女性，并且因为我们将评估与女性有关的压力源。将使用验证良好的调查工具评估压力感知和暴露。所有受试者将接受应力反应生理学的评估，包括昼夜皮质醇和心理心脏率变异性，以监测自主活动。要测试的具体目标如下： 具体目的1：在存在或不存在纤维肌痛（FM）的情况下，就症状和压力生理学的严重程度进行比较。 具体目的2：确定社会心理压力与痛苦和症状概况之间的关联，诊断组（TMD�FM，n = 30和健康匹配的对照，n = 15）和压力生理学。 Stress exposure measures and psychosocial phenotyping include the MINI Neuropsychiatric Interview, SF-12v2, CES-D, Scl-90R, MASQ, PSQI, Gracely Pain Scale, McGill Pain Questionnaire, Hassles & Uplifts Sclare, Perceived Stress Scale, PCL-C, Job Content Questionnaire, National Violence Against Women Survey, and the Psychological Maltreatment of Womens Inventory. 压力生理表型包括昼夜唾液皮质醇水平，以评估饮食后30分钟时30分钟的唾液皮质醇测量，以评估刺激的HPA轴功能，心率变异性和皮肤电导率。我们还将测量血清白介素6（IL-6）和C反应蛋白（CRP）水平，以评估广义免疫系统激活。